Systemic lipid peroxidation and inflammation induced by thermal injury persists into the post-resuscitation period.
We determined the time course of the oxidant-induced systemic lipid peroxidation seen after burn injury. Twelve sheep were given a 15% of total body surface third-degree burn and monitored for 3 or 5 days. Circulating lipid peroxides were monitored by both malondialdehyde (MDA) and conjugated dienes (CD). Lung and liver tissue MDA was also measured and compared to controls. A significant but transient increase in circulating MDA and CD was noted several hours after burn. Venous plasma levels increased again 3-5 days postburn with onset of wound inflammation. Oxygen consumption, VO2, also increased by 35 +/- 12% at this time. Lung MDA, which increased to 64 +/- 5 from a control of 45 +/- 4 nMol/gm, at 12 hours after burn was still increased 3 days after injury. Marked lung inflammation was present early after injury and persisted for the 5-day study period. Liver MDA also increased from control value of 110 +/- 20 to 252 +/- 25 at 12 hours and remained increased over the 5-day period. Serum alkaline phosphatase was also increased. Burn biopsies revealed no infection to explain the ongoing lipid peroxidation process, i.e., bacterial content was less than 10(5) organisms/gram burn tissue. We conclude that an initial system lipid peroxidation occurs immediately after burn injury, and that this process continues well into the post-resuscitation period, corresponding in time with increased VO2, lung inflammation, and evidence of liver dysfunction. The ongoing oxidant changes with the presence of a burn may explain the accentuated organ dysfunction seen with an additional septic insult in burned patients.
Demling
R H
RH
Longwood Area Trauma Center, Brigham and Women's, Beth Israel, Boston, MA 02115.
Lalonde
C
C
D015121:6-Ketoprostaglandin F1 alpha / Q000378:metabolism; D000818:Animals; D002056:Burns / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D007249:Inflammation / Q000209:etiology / Q000378:metabolism; D015227:Lipid Peroxidation / Q000502:physiology*; D008099:Liver / Q000378:metabolism; D008168:Lung / Q000473:pathology; D008315:Malondialdehyde / Q000378:metabolism; D010101:Oxygen Consumption; D011014:Pneumonia / Q000209:etiology / Q000473:pathology; D012756:Sheep; D013929:Thromboxane B2 / Q000378:metabolism; D013997:Time Factors
D008315:Malondialdehyde; D013929:Thromboxane B2; D015121:6-Ketoprostaglandin F1 alpha